Provider Demographics
NPI:1013317437
Name:MCGUIGAN, MEAGAN (LPN)
Entity Type:Individual
Prefix:MISS
First Name:MEAGAN
Middle Name:
Last Name:MCGUIGAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 CREIGHTON AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE RONKONKOMA
Mailing Address - State:NY
Mailing Address - Zip Code:11779-4416
Mailing Address - Country:US
Mailing Address - Phone:631-774-0565
Mailing Address - Fax:
Practice Address - Street 1:14 CREIGHTON AVE
Practice Address - Street 2:
Practice Address - City:LAKE RONKONKOMA
Practice Address - State:NY
Practice Address - Zip Code:11779-4416
Practice Address - Country:US
Practice Address - Phone:631-774-0565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY295720-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse